RACIAL COMPARISONS OF RECEPTIVITY TO A BLOOD-BASED BIOMARKER TEST FOR ALZHEIMER RISK

Abstract Blood-based biomarker (BBB) tests to assess risk for developing Alzheimer disease (AD) have recently been approved for clinical use. Little is known about people’s interest and concerns about these new tests, although the relative simplicity of the tests may help reduce disparities in early diagnosis for AD in historically marginalized groups, such as African Americans. The current report uses data from a national survey of adults in the United States (N = 1,274) conducted in 2022, oversampling African Americans. In addition to demographic questions, respondents rated the importance of different factors they would weigh when deciding whether to take a BBB test and their trust with the healthcare system. The sample was diverse in age (M = 48.6, SD = 17.6, range = 18-91), balanced in gender (55.3% female) and race (48.1% African American), and ranging in education (41.1% < BA). A higher percentage of respondents rated the accuracy (69.2%) and usefulness (64.5%) of the test as very important to their decision, compared to cost (40.8%) and convenience (38.0%). However, African Americans rated cost, convenience, confidentiality, and the potential for learning about other medical problems as more important than White respondents (chi-square p’s < .01). Contrary to hypotheses, trust in the healthcare system was not significantly related to decisional factors. Results from this study have implications for how to tailor culturally sensitive messages about new tests for the early detection of dementia risk.

Nutrition, Columbus,Ohio,United States,2. National Institutes of Health,Bethesda,Maryland,United States,3. Abbott,Granada,Andalucia,Spain Quality of life (QoL) is important for healthy aging, both for older adults themselves and healthcare providers/ systems caring for them.Eating/nutritious food are essential for maintaining good nutrition status, provide pleasure, help older adults remain healthy/independent, and contribute to important QoL domains.Yet research on nutrition and QoL is limited.This study describes connections between QoL and nutrition by examining QoL instruments and nutrition screening tools used with community-living older adults.20 validated QoL instruments were evaluated to determine if they included nutrition-related items involving 8 previously identified QoL domains.75% of QoL screening tools included at least 1 nutrition-related item, most commonly in autonomy (n=11), physical health (n=7), social connection (n=3), environment (n=3), emotional state (n=2), mental health (n=2), and personhood (n=1) domains; none in spiritual feeling domain.16 validated nutrition screening tools were evaluated to determine how their nutrition items related to the same specific QoL domains; all tools included at least 1 nutrition item related to physical health (n=16).Other domains represented by nutrition items were autonomy (n= 9), emotional state (n=5), social connection (n=5), environment (n=4), and mental health (n=3).Although commonalities existed between QoL instruments and nutrition screening tools in types of nutrition-related items included, there were many inconsistencies/gaps.Only 1 QoL instrument and no nutrition screening tools included items in the personhood domain that were related to enjoyment in eating.Nutrition is a potentially modifiable factor benefiting healthy aging and QoL outcomes; these gaps represent opportunities for further research and policy and program development.

QUALITY OF LONG-TERM CARE FACILITIES AND COVID-19 OUTCOMES: A SYSTEMATIC REVIEW
Xiaochuan Wang, and Gabriella Eyler, University of Central Florida, Orlando, Florida, United States U.S. long-term care facilities (LTCFs) have been disproportionally and negatively impacted by the COVID-19 pandemic, reporting high shares of COVID-19 cases and deaths.It is critical to understand whether and how quality of these facilities is related to COVID-19 outcomes, to inform policy and practice to better protect the vulnerable LTCF residents and prepare for future outbreaks.Yet, research on this topic has primarily focused on nursing homes which has yielded inconsistent findings, and less is known in the assisted living care setting.To help address this gap, we systematically reviewed existing literature describing quality indicators and examining their impacts on COVID-19 outcomes in LTCFs.Using PRISMA guidelines, we searched electronic databases (e.g., PubMed) for peer-reviewed articles published in English between 2020 and 2023.The search yielded 1,487 unduplicated publications.After screening articles for relevance based on titles and abstracts, 123 were reviewed in full text.A total of 25 articles were included in this review.The included articles examined a range of quality indicators, such as CMS overall and sub-domain 5-star ratings and previous infection prevention and control deficiencies.Overall, the studies revealed mixed results regarding the association between quality and COVID-19 outcomes in LTCFs.Most studies found that higher quality is generally indicative of better COVID-19 outcomes, and some further suggested that the association varied across pandemic phases.Whereas another 7 studies found no significant relationship.This systematic review highlights the need for future research and evidenced-based policy and practice to better protect the at-risk LTCF resident population.Social isolation has been linked to cognitive impairment.Research on this relationship, however, remains limited because validated social isolation measures have been underutilized when examining dementia risk, while also considering differences among racial-ethnic groups.To address this gap, we analyzed 11 years of data (2011-2021) from the National Health and Aging Trends Study to examine the interplay between social isolation, race-ethnicity, and dementia.We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling U.S. adults aged 65 years and older.After applying sampling weights and imputing missing data, our analysis revealed a higher average longitudinal frequency of social isolation among Black (27.6%),Hispanic (26.6%), and Asian (21.0%) older adults compared to non-Hispanic White (19.1%)respondents during the 11-year period (t=-7.35,p<.001).Cox regression models indicated higher frequency of social isolation was significantly associated with a 45% increased dementia risk after adjusting for sociodemographic covariates (adjusted Hazard Ratio [aHR]=1.45,95% CI=1.14-1.84,p<.01), but this association was non-significant after further adjusting for health covariates (aHR=1.16,95% CI=0.92-1.46, p=.20).Race-ethnicity was also not a significant moderator in the association between social isolation and dementia.Our results suggest older adults of color experience higher longitudinal frequency of social isolation.Despite the elevated dementia risk we observed among older adults with higher social isolation, race-ethnicity did not moderate this relationship.Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities for social isolation, and develop targeted interventions to mitigate the associated risk for dementia.
diagnosis for AD in historically marginalized groups, such as African Americans.The current report uses data from a national survey of adults in the United States (N = 1,274) conducted in 2022, oversampling African Americans.In addition to demographic questions, respondents rated the importance of different factors they would weigh when deciding whether to take a BBB test and their trust with the healthcare system.The sample was diverse in age (M = 48.6,SD = 17.6, range = 18-91), balanced in gender (55.3% female) and race (48.1% African American), and ranging in education (41.1% < BA).A higher percentage of respondents rated the accuracy (69.2%) and usefulness (64.5%) of the test as very important to their decision, compared to cost (40.8%)and convenience (38.0%).However, African Americans rated cost, convenience, confidentiality, and the potential for learning about other medical problems as more important than White respondents (chi-square p's < .01).Contrary to hypotheses, trust in the healthcare system was not significantly related to decisional factors.Results from this study have implications for how to tailor culturally sensitive messages about new tests for the early detection of dementia risk.

RACIAL DIFFERENCES IN HEARING LOSS AMONG MIDDLE-AGED AND OLDER ADULTS Jessica West, Sherri Smith, and Matthew Dupre, Duke University, Durham, North Carolina, United States
Prior studies have documented how social and systemic factors contribute to racial differences in health; however, less is known about the life course and social determinants of racial differences in hearing loss (HL) among middle-aged and older adults.Evidence from U.S. population-based cohorts indicates that Black adults have better pure-tone thresholds and a 40-70% lower prevalence of HL compared to White adults.However, beyond documenting racial differences in general hearing sensitivity (i.e., degree of HL), it is unknown how the characteristics of HL (e.g., type, laterality, etc.) vary by race.Using ICD codes and the AMCLASS classification system, we will evaluate types of HL (e.g., sensorineural, conductive, and mixed HL); symmetry categories (e.g., symmetrical or asymmetrical HL); and severity categories (by classifying pure-tone average according to standard metrics: normal [-10-15 dB HL], slight [16][17][18][19][20][21][22][23][24][25], moderate [41-55 dB HL], moderately severe [56-70 dB HL], severe [71-90 dB HL], and profound [>90 dB HL]).We will examine audiological data on 22,905 adults aged 50 and older (17.9% Black, 82.1% White) using electronic health records (EHR) and linked area-level data from a large healthcare system.We will also investigate how socioeconomic (e.g., education, income, health insurance), psychosocial (e.g., mental health), behavioral (e.g., smoking), and clinical factors (e.g., disease comorbidities) are associated with HL characteristics in White and Black adults.Findings will provide important and actionable insights into racial differences in HL.

RACIAL DIFFERENCES IN THE RELATIONSHIP BETWEEN LONELINESS AND COGNITION AMONG OLDER ADULTS IN THE MIDWEST
Wade Catt 1 , Nicole Fowler 1 , Brea Perry 2 , Siyun Peng 2 , and Monica Williams-Farrelly 1 , 1. Indiana University School of Medicine,Indianapolis,Indiana,United States,2. Indiana University,Bloomington,Indiana,United States Findings from various studies have revealed a relationship between loneliness and negative health outcomes, including cognitive decline and dementia.The strength and direction of this relationship has been contested as there is wide variability in definitions and testing criteria for loneliness.If loneliness is risk factor for cognitive decline, it may represent a cost-effective site for interventional design.We used data from the Precision Health Initiative's Person to Person Health Interview Study (P2P), a cross-sectional survey conducted in Indiana from 2020-2021, to investigate the relationship between loneliness (UCLA 3-item loneliness scale) and cognition (The Montreal Cognitive Assessment; MoCA) among older adults and to determine if the strength of the relationship varies for black and white adults.Among our subsample of adults 55 and older, over one quarter (26.7%) reported loneliness, with white respondents reporting more loneliness than black respondents (26.8 and 22.0%, respectively).Being lonely was associated with lower cognition, as was being older, male, black, and having no college education.However, we found that loneliness was associated with worse cognition, for white adults only.Although black respondents in our sample reported more loneliness than older white adults after age 70, we did not have adequate power to determine if advanced age moderated the relationship.Our findings highlight the role of loneliness in cognition for older, white adults and the need for more research to assess this relationship for the "mid-" and "oldest-old" black adults who may be more susceptible to loneliness due, in part, to racial disparities in mortality.Racial discrimination is a chronic psychosocial stressor that can accelerate aging.Characterizing longitudinal patterns of racial discrimination may provide greater precision in predicting health risk particularly for outcomes such as multimorbidity that is considered a proxy of multisystem dysregulation and a marker of cumulative disease burden.However, longitudinal patterns of racial discrimination and its relationship with multimorbidity has received limited attention.We investigate the association between racial discrimination trajectories (RDT) and multimorbidity among a subsample of middle-aged and older Black adults from the Health andRetirement Study (2006-2020, N = 2,167, 50+).RDTs were constructed based on the Everyday Discrimination Scale using repeated measures latent profile analyses.Multimorbidity was operationalized using the multimorbidity weighted index (MWI) score.Linear mixed models, adjusted for sociodemographic, behavioral, and clinical covariates, estimated the association between RDT and MWI score and change in score over time.Average MWI scores varied across RDT classes: low (5.9), moderate (6.5), and high (5.9).Individuals characterized in the moderate

RACIAL AND ETHNIC DISPARITIES IN SOCIAL ISOLATION AND 11-YEAR DEMENTIA RISK AMONG OLDER ADULTS IN THE UNITED STATES Jason
Grullon, Daniel Soong, and Roger Wong, SUNY Upstate Medical University, Syracuse, New York, United States